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The nurse has conducted a stress management seminar for clients in an ambulatory care setting. Which statement by a client would indicate a need for further teaching?
- A. I can use those guided imagery techniques I've learned anywhere and anytime.
- B. Biofeedback might be nice, but I don't like the idea of having to use equipment.
- C. Using confrontation with coworkers should solve my problems at work quickly.
- D. The progressive muscle relaxation technique should ease my tension headaches.
Correct Answer: C
Rationale: Confrontation is a communication technique, not a stress management technique. It may also exacerbate stress, at least in the short term, rather than alleviate it. Biofeedback, progressive muscle relaxation, meditation, and guided imagery are techniques that the nurse can teach the client to reduce the physical impact of stress on the body and promote a feeling of self-control for the client. Biofeedback entails electronic equipment, whereas the others require no adjuncts, such as tapes, once the technique is learned.
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The nurse is caring for a client with a history of burns. Which of the following psychosocial interventions should be included in the plan of care?
- A. Encourage expression of feelings.
- B. Restrict family visits.
- C. Limit social interactions.
- D. Provide sedatives routinely.
Correct Answer: A
Rationale: Encouraging expression of feelings supports emotional coping in burn recovery.
The nurse is caring for a client who has just had a mastectomy. Which exercise should the nurse assist the client in doing during the first 24 hours after surgery?
- A. Hand wall climbing
- B. Pendulum arm swings
- C. Elbow flexion and extension
- D. Shoulder abduction and external rotation
Correct Answer: C
Rationale: During the first 24 hours after surgery, the client is assisted to move the fingers and hands, and to flex and extend the elbow. The client may also use the arm for self-care provided that she does not raise the arm above shoulder level or abduct the shoulder. The exercises identified in the remaining options are done once surgical drains are removed and wound healing is well established.
The nurse is assessing a client with a suspected tension pneumothorax. Which of the following findings is most indicative of this condition?
- A. Symmetrical chest movement.
- B. Tracheal deviation to the affected side.
- C. Dull percussion note on the affected side.
- D. Absent breath sounds on the affected side.
Correct Answer: B,D
Rationale: Tracheal deviation to the unaffected side and absent breath sounds on the affected side are hallmark signs of tension pneumothorax due to mediastinal shift and lung collapse.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed budesonide (Pulmicort). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Use the inhaler as needed for shortness of breath.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after budesonide inhalation prevents oral thrush.
A client with schizophrenia is responding well to risperidone (Risperdal) and is no longer psychotic. After teaching the client about managing his illness, which of the following statements reflects a need for further education?
- A. I just don't know if I can afford to keep taking medicines every day
- B. When my thoughts start racing, I know I need to relax more
- C. I can name the side effects of Risperdal, but I'm not having any
- D. I don't listen to my mom's religious beliefs about not using medicines
Correct Answer: A
Rationale: Concern about affording daily medication suggests a need for further education on resources or adherence strategies, as non-adherence risks relapse. Other statements reflect appropriate understanding.